Naturopath vs medical doctor: training, scope and working together

A naturopathic doctor (ND) and a medical doctor are two different regulated professions in Ontario. They train in different programs, answer to different colleges and work under different laws. NDs are regulated under the Naturopathy Act, 2007, and medical doctors under the Medicine Act, 1991. They aren't either-or. They can work alongside each other.

Two jobs, two sets of rules.

This is a question about jobs, not a contest. Each profession has its own training, its own rules and its own limits. Knowing them makes it easier to use both well.

Here is what each one involves, from the regulators' own pages.

Two professions, two colleges.

Both professions sit under Ontario's Regulated Health Professions Act, 1991. Each has its own college and its own Act.

• Naturopathic Doctors are regulated by the College of Naturopaths of Ontario (CONO), under the Naturopathy Act, 2007.
• Physicians are regulated by the College of Physicians and Surgeons of Ontario (CPSO), under the Medicine Act, 1991.

Each college keeps a public register. CONO's lists every registered ND. The CPSO's is called the Medical doctor Register. Either one lets you look someone up by name.

How an ND trains.

NDs train at a naturopathic college, not a medical school. The Canadian College of Naturopathic Medicine in Toronto runs a four-year naturopathic program. To apply, you need a three or four year bachelor's degree first, plus science prerequisites.

To practise in Ontario, an ND then registers with CONO. That means passing the College's entry-to-practise exams. CONO lists them as:

• the Ontario Biomedical Examination
• the Ontario Clinical Sciences Examination
• the Ontario Clinical (Practical) Exams
• a jurisprudence course and exam on Ontario's rules

People trained outside an accredited program go through a separate assessment route. Prescribing needs one more step, covered below.

How a medical doctor trains.

The CPSO lists the general requirements for a certificate to practise independently in Ontario:

• a medical degree from an accredited or acceptable medical school
• Parts 1 and 2 of the Medical Council of Canada Qualifying Examination
• certification by exam from the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada
• one year of postgraduate training or active practice in Canada

That's the path your family doctor took.

What the law lets each one do.

Each Act starts with a scope of practice. It's a one-sentence summary of the job.

• Naturopathy: the assessment of diseases, disorders and dysfunctions, and their naturopathic diagnosis and treatment, "using naturopathic techniques."
• Medicine: the assessment of a person's physical or mental condition, and the diagnosis, treatment and prevention of any disease, disorder or dysfunction.

Each Act then lists its own controlled acts. For an ND, the list includes communicating a naturopathic diagnosis and taking blood samples for prescribed examinations. Ontario NDs can also requisition certain lab tests.

Prescribing works differently for each. An ND may prescribe only drugs listed in Table 3 of the General Regulation, within its limits. An ND must also first pass a College-approved course and exam in therapeutic prescribing. The register shows who has.

Where the ND's job ends, and the medical doctor's starts.

Ontario's rules spell out when an ND must refer you on. Under O. Reg. 168/15, an ND must refer you to a medical doctor or a nurse practitioner when:

• your condition is beyond the naturopathic scope, for diagnosis or for treatment
• your care needs testing, monitoring or treatment technology outside the naturopathic scope
• a lab result comes back at a critical value
• you're not responding to the plan, and the ND's other options won't change that

And if your life may be at risk, the ND must call emergency services. Not for emergencies. In an emergency, call 911.

How they work alongside each other.

The ND works alongside your family doctor, not instead of them. With your permission, the ND shares what they find. If something needs a medical doctor or nurse practitioner, the ND tells you plainly and refers you.

A few habits make that easier

• Tell both of them. Your family doctor should know you see an ND. The ND should know what your family doctor has found.
• Bring your results. Recent bloodwork from your family doctor is part of the ND's picture. It may mean nothing new needs to be ordered.
• List everything you take. Medications and supplements, or photos of the labels, so any plan fits around them.

How to check who you're seeing.

Look for the title. In Ontario, an ND may use the title Doctor only with "ND" or "Naturopathic Doctor" right after the name.

Then check the register. The same number is printed on every receipt. Meet the ND

Questions people ask